This grant application is for the 5th and final year of the present University of Miami Comprehensive Sickle Cell Center grant, which was established at the University of Miami in 1973. The Center is composed of four major divisions: patient care; education, testing and counseling; basic research; and administration. The aims of the Center will be to promote community, health personnel, and patient education; to provide testing and counseling; to facilitate more comprehensive and coordinated care of persons with sickle cell diseases; and to foster research of these diseases. Patient care will center around the Sickle Cell Clinic established in the Jackson Memorial Hospital Out-Patient Clinics in 1972. The physicians, nurses, nurse practitioner and two social workers combine to deliver the best care available to over 250 adults and children with sickle cell diseases. Educational efforts will be the primary function of the Community Education, Testing and Counseling Program. Through arrangements with community health centers around Dade County, the Center has access to most of the areas in which blacks reside. This Program will provide indivdual education, testing and counseling; establish a genetics educational unit in the high schools; provide lectures for lay and professional groups; train health educators and technicians; and provide for general public education through the media and a newsletter. The research component consists of 5 separate projects including studies on the effects of diphosphonates on erythrocyte calcium loading and red cell maturation in the chick embryo; the deficiency in complement-dependent humoral immunity in sickle cell disease; cyanate effect upon host defense, cellular and humoral; biochemical and morphological parameters of sickle cells; and the fetal to adult hemoglobin switch mechanism in an animal model.